Temporary Drainage Procedures in Pregnancy

Temporizing drainage procedures in pregnant females pose additional treatment-related concerns warranting comment. Because of physiologic changes in renal function during pregnancy resulting in hypercalcuria and hyperuricosuria, encrustation of stents and percutaneous nephrostomy tubes can occur (McAleer and Loughlin 2004; Evans and Wollin 2001). Pregnant women with stents are therefore recommended to have stent exchanges approximately every 4-6 weeks to prevent this problem. For a woman in the first or second trimester, the need for multiple stent exchanges is a disadvantage and could potentially be associated with complications putting the fetus at risk. In addition, the impact of typical stent-related irritations such as pain, he-maturia, infection, and lower urinary tract voiding symptoms may be greater in the pregnant female.

Nephrostomy tubes are likewise associated with similar irritations and because of encrustation or blockage must also be frequently exchanged. With nephrostomy tubes, other disadvantages include the risk of traumatic removal and the need for wearing an external collection bag potentially for the duration of the pregnancy. Despite the disadvantages, the traditional treatment of pregnant females requiring a temporizing treatment is unchanged from other patient populations.

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